Guided Lecture Notes
Chapter 25: Renal Failure
Learning Objective 1. Distinguish between acute and chronic renal failure in terms of
causes, treatment, and outcome.

Compare the onset and outcomes of acute and chronic renal failure (refer to
PowerPoint Slide 2).
Learning Objective 2. Differentiate among the prerenal, intrinsic, and postrenal forms
of acute renal failure in terms of mechanisms of development and manifestations.

Compare prerenal, postrenal, and intrinsic ARF with regard to causes, pathology,
clinical manifestations, treatment, and laboratory test results (refer to PowerPoint
Slide 3, Chart 25-1, and Fig. 25-1).
Learning Objective 3. Cite the two most common causes of acute tubular necrosis and
describe the course of the disease in terms of the initiation, maintenance, and recovery
phases.

Classify ATN (intrinsic ARF), and describe its etiology, phases of progression,
clinical manifestations, diagnosis, and treatment (refer to PowerPoint Slides 6–9
and Fig. 25-2).
Learning Objective 4. State what is meant by diminished renal reserve, renal
insufficiency, renal failure, and end-stage renal disease.

Describe the stages of progression of CRF, including diminished renal reserve,
renal insufficiency, and end-stage renal disease (refer to PowerPoint Slide 11).

Relate renal function to nephron mass, GFR, BUN, and creatinine levels (refer to
PowerPoint Slide 12 and Fig. 25-3).
Learning Objective 5. List the common problems associated with end-stage renal
disease, including alterations in fluid and electrolyte balance and disorders of skeletal,
hematologic, cardiovascular, immune, neurologic, skin, and sexual function, and explain
their physiologic significance.

Describe the mechanisms and manifestations of CRF on other body systems (refer
to PowerPoint Slides 12, 17–18, and Fig. 25-4).

Explain how these manifestations relate to end-stage renal disease.
Learning Objective 6. State the basis for adverse drug reactions in patients with endstage renal disease.

Describe the role of the kidneys in drug metabolism and elimination.

Explain the reason for a drug’s adverse/side effects due to end-stage renal disease.
Learning Objective 7. Describe the scientific principles underlying dialysis treatment,
and compare hemodialysis with peritoneal dialysis.

Discuss medical treatment options, dialysis, and transplantation in CRF.

Differentiate between hemodialysis and peritoneal dialysis (refer to Figs. 25-5
and 25-6).
Learning Objective 8. State the goals for dietary management of persons with end-stage
renal disease.

State the goal of dietary management of CRF, and discuss various diet options,
weighing their advantages and disadvantages.